PATIENT FORMS AND EDUCATION

FORMS

Save time at the office. Complete forms and review documents before your visit.

Forms may be completed on your computer and printed or you may complete them by hand.  If you are a new patient, download our new patient packet containing many of the documents you will be asked to complete or review on your first visit and answers to some of the questions you may have. If you do not print the documents and bring them to your appointment, you will be given blank copies of any necessary documents when you check-in. Established patients may also request copies of important forms, policies and notices when you visit our office. Please bring any vaccine records you have for your child to their first visit so that they can be put into the State Vaccine System.

New Patient Intake Packet

Newborn Intake Packet

18+ Adult Form

Medical Record Release

Breastfeeding and Lactation

Risk Factors

Education

Prenatal Information

2 Week Well Child Education Packet

2 Month Well Child Education Packet

4 Month Well Child Education Packet

6 Month Well Child Education Packet

9 Month Well Child Education Packet

12 Month Well Child Education Packet

15-18 Month Well Child Education Packet

2-2.5 Year Well Child Education Packet

3 Year Well Child Education Packet

4 Year Well Child Education Packet

5-6 Year Well Child Education Packet

7-8 Year Well Child Education Packet

9-10 Year Well Child Education Packet

Policies

Office and Financial Policy

Well-Child Services Policy

Office Vaccination Policy

Notice of Privacy Policies and Practices

Notice Informing Individuals About Nondiscrimination and Accessibility Requirements

Website Disclaimers and Notices

Other Documents

Well-Child and Immunization Schedules

Pediatric Dentist Recommendations

Psychologist Recommendations

Current Child Restraint Laws/Guidelines

Tylenol/Motrin Dosing Guide

Accepted Insurances